[
  {
    "question": "What is the primary role of the EMT in an EMS system?",
    "choices": [
      "Provide basic emergency medical care",
      "Diagnose medical conditions",
      "Perform advanced airway procedures",
      "Prescribe medications"
    ],
    "answer": "Provide basic emergency medical care"
  },
  {
    "question": "What is an example of off-line medical direction?",
    "choices": [
      "Direct supervision",
      "Real-time orders by radio",
      "Standing orders",
      "Calling the medical director"
    ],
    "answer": "Standing orders"
  },
  {
    "question": "Which level of EMS provider can perform advanced airway management?",
    "choices": [
      "Paramedic",
      "AEMT",
      "EMT",
      "EMR"
    ],
    "answer": "Paramedic"
  },
  {
    "question": "What does CQI stand for in EMS systems?",
    "choices": [
      "Continuous Quality Improvement",
      "Clinical Quantitative Index",
      "Certified Quality Initiative",
      "Continuous Quantitative Instruction"
    ],
    "answer": "Continuous Quality Improvement"
  },
  {
    "question": "Who provides on-line medical direction?",
    "choices": [
      "EMT partner",
      "Physician via radio or phone",
      "Medical assistant",
      "Dispatch center"
    ],
    "answer": "Physician via radio or phone"
  },
  {
    "question": "What must be obtained before providing care to a conscious adult?",
    "choices": [
      "Parental consent",
      "Expressed denial",
      "Implied consent",
      "Informed consent"
    ],
    "answer": "Informed consent"
  },
  {
    "question": "Which of the following is an example of implied consent?",
    "choices": [
      "Child with parent present",
      "Refusing care after being informed",
      "Signing a waiver",
      "Unconscious trauma patient"
    ],
    "answer": "Unconscious trauma patient"
  },
  {
    "question": "What is the term for unlawful touching of a patient without consent?",
    "choices": [
      "Battery",
      "Assault",
      "Negligence",
      "Abandonment"
    ],
    "answer": "Battery"
  },
  {
    "question": "What should you do if a patient refuses care?",
    "choices": [
      "Leave immediately",
      "Call police",
      "Force treatment",
      "Explain risks and document refusal"
    ],
    "answer": "Explain risks and document refusal"
  },
  {
    "question": "What is the legal term for terminating care without transfer?",
    "choices": [
      "Malpractice",
      "Negligence",
      "Battery",
      "Abandonment"
    ],
    "answer": "Abandonment"
  },
  {
    "question": "Which organ is responsible for pumping blood throughout the body?",
    "choices": [
      "Lungs",
      "Heart",
      "Liver",
      "Kidney"
    ],
    "answer": "Heart"
  },
  {
    "question": "Which body system includes the brain and spinal cord?",
    "choices": [
      "Digestive system",
      "Respiratory system",
      "Nervous system",
      "Endocrine system"
    ],
    "answer": "Nervous system"
  },
  {
    "question": "Which system is responsible for gas exchange?",
    "choices": [
      "Urinary system",
      "Respiratory system",
      "Nervous system",
      "Digestive system"
    ],
    "answer": "Respiratory system"
  },
  {
    "question": "Which organ is part of the digestive system?",
    "choices": [
      "Heart",
      "Trachea",
      "Stomach",
      "Larynx"
    ],
    "answer": "Stomach"
  },
  {
    "question": "Which bones protect the brain?",
    "choices": [
      "Spinal vertebrae",
      "Pelvis",
      "Ribs",
      "Cranial bones"
    ],
    "answer": "Cranial bones"
  },
  {
    "question": "What is the function of alveoli in the lungs?",
    "choices": [
      "Sound production",
      "Protect against infection",
      "Gas exchange",
      "Air filtration"
    ],
    "answer": "Gas exchange"
  },
  {
    "question": "What vessel carries oxygenated blood from the lungs to the heart?",
    "choices": [
      "Pulmonary vein",
      "Vena cava",
      "Aorta",
      "Pulmonary artery"
    ],
    "answer": "Pulmonary vein"
  },
  {
    "question": "Which part of the heart pumps blood to the body?",
    "choices": [
      "Left atrium",
      "Right atrium",
      "Right ventricle",
      "Left ventricle"
    ],
    "answer": "Left ventricle"
  },
  {
    "question": "Which blood cells help fight infection?",
    "choices": [
      "Red blood cells",
      "Platelets",
      "Plasma",
      "White blood cells"
    ],
    "answer": "White blood cells"
  },
  {
    "question": "Which structure prevents food from entering the airway?",
    "choices": [
      "Larynx",
      "Trachea",
      "Epiglottis",
      "Esophagus"
    ],
    "answer": "Epiglottis"
  },
  {
    "question": "The prefix 'tachy-' means:",
    "choices": [
      "Slow",
      "Large",
      "Pain",
      "Fast"
    ],
    "answer": "Fast"
  },
  {
    "question": "The suffix '-itis' refers to:",
    "choices": [
      "Condition",
      "Pain",
      "Infection",
      "Inflammation"
    ],
    "answer": "Inflammation"
  },
  {
    "question": "The term 'hypoglycemia' means:",
    "choices": [
      "High calcium",
      "Low blood sugar",
      "Low oxygen",
      "High blood sugar"
    ],
    "answer": "Low blood sugar"
  },
  {
    "question": "The prefix 'brady-' means:",
    "choices": [
      "Below",
      "Fast",
      "Slow",
      "Above"
    ],
    "answer": "Slow"
  },
  {
    "question": "The root word 'cardio' refers to:",
    "choices": [
      "Heart",
      "Brain",
      "Liver",
      "Lungs"
    ],
    "answer": "Heart"
  },
  {
    "question": "Which of the following is a common early sign of shock?",
    "choices": [
      "Hypertension",
      "Flushed skin",
      "Bradycardia",
      "Tachycardia"
    ],
    "answer": "Tachycardia"
  },
  {
    "question": "What type of shock results from fluid loss?",
    "choices": [
      "Obstructive shock",
      "Distributive shock",
      "Cardiogenic shock",
      "Hypovolemic shock"
    ],
    "answer": "Hypovolemic shock"
  },
  {
    "question": "Which condition is most likely to lead to cardiogenic shock?",
    "choices": [
      "Asthma",
      "Seizure",
      "Heart attack",
      "Stroke"
    ],
    "answer": "Heart attack"
  },
  {
    "question": "What is a late sign of shock?",
    "choices": [
      "Drop in blood pressure",
      "Pale skin",
      "Anxiety",
      "Increased pulse"
    ],
    "answer": "Drop in blood pressure"
  },
  {
    "question": "Which organ is most sensitive to inadequate perfusion?",
    "choices": [
      "Brain",
      "Skin",
      "Stomach",
      "Liver"
    ],
    "answer": "Brain"
  },
  {
    "question": "Which age group is most likely to have separation anxiety during assessment?",
    "choices": [
      "Toddlers",
      "Adolescents",
      "Adults",
      "Neonates"
    ],
    "answer": "Toddlers"
  },
  {
    "question": "How should you communicate with an elderly patient who is hard of hearing?",
    "choices": [
      "Speak clearly and slowly",
      "Raise your voice and speak quickly",
      "Use medical jargon",
      "Ignore their hearing difficulty"
    ],
    "answer": "Speak clearly and slowly"
  },
  {
    "question": "Which age group is most likely to underreport pain?",
    "choices": [
      "Geriatric patients",
      "Teens",
      "Infants",
      "Adults"
    ],
    "answer": "Geriatric patients"
  },
  {
    "question": "Which is a normal heart rate for a neonate?",
    "choices": [
      "60\u2013100 bpm",
      "160\u2013200 bpm",
      "120\u2013160 bpm",
      "100\u2013120 bpm"
    ],
    "answer": "120\u2013160 bpm"
  },
  {
    "question": "Which age group commonly presents with nonspecific symptoms in serious illness?",
    "choices": [
      "Adults",
      "Geriatrics",
      "Teens",
      "Infants"
    ],
    "answer": "Geriatrics"
  },
  {
    "question": "Which action represents EMS involvement in public health?",
    "choices": [
      "Waiting for hospital orders",
      "Treating only emergency calls",
      "Providing vaccinations at community events",
      "Filing insurance claims"
    ],
    "answer": "Providing vaccinations at community events"
  },
  {
    "question": "What is one goal of community paramedicine?",
    "choices": [
      "Transport all patients",
      "Increase 911 calls",
      "Focus only on trauma",
      "Prevent hospital readmissions"
    ],
    "answer": "Prevent hospital readmissions"
  },
  {
    "question": "Which is a benefit of EMS data collection?",
    "choices": [
      "Eliminates all errors",
      "Improves public health planning",
      "Reduces scene time",
      "Shortens hospital stays"
    ],
    "answer": "Improves public health planning"
  },
  {
    "question": "How can EMS help during a disease outbreak?",
    "choices": [
      "Assist with screening and education",
      "Treat only trauma",
      "Transport without PPE",
      "Avoid public interaction"
    ],
    "answer": "Assist with screening and education"
  },
  {
    "question": "What does public health emphasize?",
    "choices": [
      "Prevention and wellness",
      "Private treatment",
      "Emergency only",
      "Long-term care"
    ],
    "answer": "Prevention and wellness"
  },
  {
    "question": "Which medication is commonly administered for hypoglycemia?",
    "choices": [
      "Oral glucose",
      "Epinephrine",
      "Nitroglycerin",
      "Aspirin"
    ],
    "answer": "Oral glucose"
  },
  {
    "question": "Which medication is used for anaphylaxis?",
    "choices": [
      "Nitroglycerin",
      "Aspirin",
      "Albuterol",
      "Epinephrine auto-injector"
    ],
    "answer": "Epinephrine auto-injector"
  },
  {
    "question": "Which medication dilates the coronary arteries?",
    "choices": [
      "Naloxone",
      "Oral glucose",
      "Nitroglycerin",
      "Epinephrine"
    ],
    "answer": "Nitroglycerin"
  },
  {
    "question": "Which medication reverses opioid overdose?",
    "choices": [
      "Naloxone",
      "Aspirin",
      "Glucose",
      "Albuterol"
    ],
    "answer": "Naloxone"
  },
  {
    "question": "Which medication is indicated for chest pain of suspected cardiac origin?",
    "choices": [
      "Aspirin",
      "Albuterol",
      "Epinephrine",
      "Oral glucose"
    ],
    "answer": "Aspirin"
  },
  {
    "question": "What is the most appropriate airway adjunct for an unconscious patient without a gag reflex?",
    "choices": [
      "CPAP",
      "Nasopharyngeal airway",
      "Endotracheal tube",
      "Oropharyngeal airway"
    ],
    "answer": "Oropharyngeal airway"
  },
  {
    "question": "What is the best method to open the airway of a trauma patient?",
    "choices": [
      "Chin push",
      "Head-tilt chin-lift",
      "Cricoid pressure",
      "Jaw-thrust maneuver"
    ],
    "answer": "Jaw-thrust maneuver"
  },
  {
    "question": "Which device provides the highest concentration of oxygen?",
    "choices": [
      "Simple face mask",
      "Nasal cannula",
      "Bag-valve mask with reservoir",
      "Venturi mask"
    ],
    "answer": "Bag-valve mask with reservoir"
  },
  {
    "question": "What is the purpose of suctioning?",
    "choices": [
      "Deliver oxygen",
      "Monitor airway pressure",
      "Remove secretions and prevent aspiration",
      "Warm inhaled air"
    ],
    "answer": "Remove secretions and prevent aspiration"
  },
  {
    "question": "What indicates adequate artificial ventilation?",
    "choices": [
      "Decreased skin turgor",
      "Increased heart rate",
      "Visible chest rise and fall",
      "Dry mucous membranes"
    ],
    "answer": "Visible chest rise and fall"
  },
  {
    "question": "What does the 'P' in AVPU stand for?",
    "choices": [
      "Pulse",
      "Pale",
      "Pain",
      "Peripheral"
    ],
    "answer": "Pain"
  },
  {
    "question": "What is the first step in the primary assessment?",
    "choices": [
      "Form general impression",
      "Take vitals",
      "Assess SAMPLE history",
      "Begin CPR"
    ],
    "answer": "Form general impression"
  },
  {
    "question": "Which mnemonic helps assess a patient\u2019s chief complaint?",
    "choices": [
      "SAMPLE",
      "DCAP-BTLS",
      "OPQRST",
      "AVPU"
    ],
    "answer": "OPQRST"
  },
  {
    "question": "What does the 'L' in SAMPLE stand for?",
    "choices": [
      "Location",
      "Level of pain",
      "Last oral intake",
      "Laceration"
    ],
    "answer": "Last oral intake"
  },
  {
    "question": "What is a key part of the secondary assessment?",
    "choices": [
      "Performing a focused physical exam",
      "Asking insurance information",
      "Checking oxygen tank",
      "Calling for ALS backup"
    ],
    "answer": "Performing a focused physical exam"
  },
  {
    "question": "Which condition is characterized by wheezing and bronchoconstriction?",
    "choices": [
      "Seizure",
      "CHF",
      "Stroke",
      "Asthma"
    ],
    "answer": "Asthma"
  },
  {
    "question": "Which condition may present with crushing chest pain and diaphoresis?",
    "choices": [
      "Pneumonia",
      "Asthma",
      "Anxiety attack",
      "Myocardial infarction"
    ],
    "answer": "Myocardial infarction"
  },
  {
    "question": "What is a typical sign of congestive heart failure (CHF)?",
    "choices": [
      "Hives",
      "Seizure",
      "Pulmonary edema",
      "JVD"
    ],
    "answer": "Pulmonary edema"
  },
  {
    "question": "Which patient is most likely experiencing a transient ischemic attack (TIA)?",
    "choices": [
      "Severe headache and vomiting",
      "Chest pain and diaphoresis",
      "Symptoms resolve within 24 hours",
      "Persistent right-side weakness"
    ],
    "answer": "Symptoms resolve within 24 hours"
  },
  {
    "question": "Which condition is treated with albuterol?",
    "choices": [
      "Stroke",
      "Seizure",
      "Hypoglycemia",
      "Bronchospasm"
    ],
    "answer": "Bronchospasm"
  },
  {
    "question": "What is the compression rate for adult CPR?",
    "choices": [
      "80\u2013100",
      "60\u201380",
      "100\u2013120 compressions per minute",
      "120\u2013140"
    ],
    "answer": "100\u2013120 compressions per minute"
  },
  {
    "question": "How deep should compressions be on an adult?",
    "choices": [
      "Less than 1 inch",
      "2.5 inches",
      "At least 2 inches",
      "1 inch"
    ],
    "answer": "At least 2 inches"
  },
  {
    "question": "When should the AED be applied to a pulseless patient?",
    "choices": [
      "After airway is secured",
      "After 5 cycles",
      "As soon as it is available",
      "After 2 minutes of CPR"
    ],
    "answer": "As soon as it is available"
  },
  {
    "question": "Which rhythm is shockable by an AED?",
    "choices": [
      "Ventricular fibrillation",
      "Asystole",
      "Normal sinus rhythm",
      "First-degree AV block"
    ],
    "answer": "Ventricular fibrillation"
  },
  {
    "question": "What is the ratio of compressions to ventilations in two-rescuer adult CPR?",
    "choices": [
      "5:1",
      "20:2",
      "30:2",
      "15:2"
    ],
    "answer": "30:2"
  },
  {
    "question": "What is the first step in controlling external bleeding?",
    "choices": [
      "Apply direct pressure",
      "Use a tourniquet",
      "Elevate the limb",
      "Apply cold packs"
    ],
    "answer": "Apply direct pressure"
  },
  {
    "question": "Which type of bleed is most likely arterial?",
    "choices": [
      "Bright red and spurting",
      "Dark red and oozing",
      "No visible bleeding",
      "Steady flow"
    ],
    "answer": "Bright red and spurting"
  },
  {
    "question": "A burn that blisters is classified as:",
    "choices": [
      "Deep-tissue",
      "Full-thickness",
      "Partial-thickness",
      "Superficial"
    ],
    "answer": "Partial-thickness"
  },
  {
    "question": "Which sign suggests internal bleeding?",
    "choices": [
      "Rigid, distended abdomen",
      "Bradycardia",
      "Low oxygen saturation",
      "Red skin"
    ],
    "answer": "Rigid, distended abdomen"
  },
  {
    "question": "What is the best method to control bleeding from a leg amputation?",
    "choices": [
      "Cold compress",
      "Tourniquet",
      "Elevation",
      "Direct pressure only"
    ],
    "answer": "Tourniquet"
  },
  {
    "question": "What is the first step in assisting with a normal delivery?",
    "choices": [
      "Support the head as it emerges",
      "Pull the baby out",
      "Deliver the placenta",
      "Clamp the cord"
    ],
    "answer": "Support the head as it emerges"
  },
  {
    "question": "What does APGAR assess in a newborn?",
    "choices": [
      "Airway, Pulse, Gag reflex, Activity, Reflexes",
      "Alertness, Position, Gait, Activity, Response",
      "Appearance, Position, Grunt, Agitation, Reflex",
      "Appearance, Pulse, Grimace, Activity, Respirations"
    ],
    "answer": "Appearance, Pulse, Grimace, Activity, Respirations"
  },
  {
    "question": "What is the most common cause of cardiac arrest in pediatric patients?",
    "choices": [
      "Seizure",
      "Fever",
      "Respiratory failure",
      "Heart attack"
    ],
    "answer": "Respiratory failure"
  },
  {
    "question": "How should an EMT assess a child\u2019s airway?",
    "choices": [
      "Hyperextend the neck",
      "Insert an OPA immediately",
      "Use a jaw thrust on all pediatric patients",
      "Use a head tilt\u2013chin lift unless trauma suspected"
    ],
    "answer": "Use a head tilt\u2013chin lift unless trauma suspected"
  },
  {
    "question": "What is a sign of respiratory distress in infants?",
    "choices": [
      "Bradycardia",
      "Decreased level of consciousness",
      "Cool skin",
      "Nasal flaring"
    ],
    "answer": "Nasal flaring"
  },
  {
    "question": "What is the purpose of the START triage system?",
    "choices": [
      "Evacuate non-ambulatory patients",
      "Sort patients by severity",
      "Transport first arrivals",
      "Treat all patients the same"
    ],
    "answer": "Sort patients by severity"
  },
  {
    "question": "What color tag is assigned to patients who are deceased in triage?",
    "choices": [
      "Red",
      "Green",
      "Yellow",
      "Black"
    ],
    "answer": "Black"
  },
  {
    "question": "Which of the following best describes the role of the EMT at a crime scene?",
    "choices": [
      "Take photos of the scene",
      "Interview witnesses",
      "Avoid disturbing evidence while providing care",
      "Collect evidence for police"
    ],
    "answer": "Avoid disturbing evidence while providing care"
  },
  {
    "question": "When driving an ambulance with lights and sirens, what must EMTs still do?",
    "choices": [
      "Follow all traffic laws with due regard",
      "Drive at any speed",
      "Ignore traffic signals",
      "Pass on the shoulder at will"
    ],
    "answer": "Follow all traffic laws with due regard"
  },
  {
    "question": "What is a primary goal of incident command at an MCI?",
    "choices": [
      "Establish control and coordination",
      "Perform surgery",
      "Load all patients rapidly",
      "Avoid documentation"
    ],
    "answer": "Establish control and coordination"
  },
  {
    "question": "A 56-year-old male with a history of angina is complaining of chest discomfort. His vital signs are BP 124/82, HR 96, RR 18, and SpO\u2082 95%. What should you do first?",
    "choices": [
      "Administer nitroglycerin",
      "Apply oxygen via non-rebreather",
      "Assist the patient with his prescribed nitroglycerin",
      "Obtain a detailed SAMPLE history"
    ],
    "answer": "Obtain a detailed SAMPLE history",
    "reason": "The patient is stable and has a normal oxygen saturation. The first step should be assessment and history gathering before administering medications."
  },
  {
    "question": "You arrive to find a 67-year-old man slumped over the wheel of his car. He is unresponsive, breathing at 8 breaths per minute, and has a carotid pulse. What should you do?",
    "choices": [
      "Begin chest compressions",
      "Deliver oxygen via nasal cannula",
      "Ventilate with BVM at 10\u201312/min",
      "Wait for ALS before intervening"
    ],
    "answer": "Ventilate with BVM at 10\u201312/min",
    "reason": "Inadequate respiratory rate requires immediate assisted ventilations with a bag-valve mask (BVM)."
  },
  {
    "question": "Which of the following findings most clearly indicates that a patient is in compensated shock?",
    "choices": [
      "Slow capillary refill and bradycardia",
      "Cool skin, restlessness, and tachycardia",
      "Cyanosis and absent radial pulse",
      "Irregular breathing with dilated pupils"
    ],
    "answer": "Cool skin, restlessness, and tachycardia",
    "reason": "These are signs that the body is still compensating to maintain perfusion despite the onset of shock."
  },
  {
    "question": "A construction worker falls from a ladder and is found lying supine. He is conscious and complaining of back pain. What is your first priority?",
    "choices": [
      "Log-roll the patient onto the stretcher",
      "Assess vital signs",
      "Perform a rapid trauma exam",
      "Manually stabilize the cervical spine"
    ],
    "answer": "Manually stabilize the cervical spine",
    "reason": "In trauma with suspected spinal injury, immediate manual stabilization of the spine is critical to prevent further injury."
  },
  {
    "question": "Which of the following is the most appropriate action when assisting ventilations with a BVM in an adult patient?",
    "choices": [
      "Ventilate once every 3 seconds",
      "Deliver large tidal volumes to ensure chest rise",
      "Ensure a tight mask seal with two hands",
      "Use 6 L/min oxygen to conserve tank usage"
    ],
    "answer": "Ensure a tight mask seal with two hands",
    "reason": "A good seal is essential for effective ventilation and delivery of oxygen."
  },
  {
    "question": "What is the primary reason EMTs administer aspirin to a patient with chest pain?",
    "choices": [
      "To lower blood pressure",
      "To relieve pain",
      "To reduce fever",
      "To inhibit blood clotting"
    ],
    "answer": "To inhibit blood clotting"
  },
  {
    "question": "Which of the following is a contraindication for aspirin administration?",
    "choices": [
      "Chest discomfort",
      "Known allergy to aspirin",
      "History of hypertension",
      "Age over 40"
    ],
    "answer": "Known allergy to aspirin"
  },
  {
    "question": "What is the typical dose of aspirin administered by EMTs for chest pain?",
    "choices": [
      "81 mg total",
      "325 mg total",
      "400 mg total",
      "1,000 mg total"
    ],
    "answer": "325 mg total"
  },
  {
    "question": "Aspirin is most beneficial during a suspected heart attack because it:",
    "choices": [
      "Relaxes chest muscles",
      "Improves oxygen delivery",
      "Prevents clot growth",
      "Stops chest pain immediately"
    ],
    "answer": "Prevents clot growth"
  },
  {
    "question": "Under what condition can an EMT assist a patient with nitroglycerin?",
    "choices": [
      "The patient has chest trauma",
      "The patient has a prescription and systolic BP > 100 mmHg",
      "The patient is unconscious",
      "The EMT carries nitroglycerin"
    ],
    "answer": "The patient has a prescription and systolic BP > 100 mmHg"
  },
  {
    "question": "What is the typical route of nitroglycerin administration?",
    "choices": [
      "Intramuscular",
      "Oral",
      "Sublingual",
      "Intravenous"
    ],
    "answer": "Sublingual"
  },
  {
    "question": "Which condition is a contraindication to assisting with nitroglycerin?",
    "choices": [
      "Chest pain radiating to the jaw",
      "Use of erectile dysfunction medications within 48 hours",
      "History of angina",
      "Mild headache"
    ],
    "answer": "Use of erectile dysfunction medications within 48 hours"
  },
  {
    "question": "How does nitroglycerin help patients with chest pain?",
    "choices": [
      "It increases heart rate",
      "It decreases respiratory rate",
      "It dilates blood vessels to improve blood flow",
      "It constricts coronary arteries"
    ],
    "answer": "It dilates blood vessels to improve blood flow"
  },
  {
    "question": "What is the primary action of albuterol when used for a respiratory emergency?",
    "choices": [
      "Reduces mucus secretion",
      "Suppresses cough reflex",
      "Dilates the bronchioles",
      "Decreases respiratory rate"
    ],
    "answer": "Dilates the bronchioles"
  },
  {
    "question": "Which patient condition is an indication for albuterol use?",
    "choices": [
      "Chest trauma",
      "Wheezing and shortness of breath",
      "Bradycardia",
      "Nasal congestion"
    ],
    "answer": "Wheezing and shortness of breath"
  },
  {
    "question": "What is a common side effect of albuterol?",
    "choices": [
      "Slow heart rate",
      "Drowsiness",
      "Shakiness and increased heart rate",
      "Low blood sugar"
    ],
    "answer": "Shakiness and increased heart rate"
  },
  {
    "question": "EMTs may assist with albuterol if:",
    "choices": [
      "The patient is unresponsive",
      "They have verbal orders from medical control",
      "The patient has their own prescribed inhaler",
      "They carry a department-issued inhaler"
    ],
    "answer": "The patient has their own prescribed inhaler"
  },
  {
    "question": "What is the main effect of epinephrine during anaphylaxis?",
    "choices": [
      "Promotes digestion",
      "Constricts airways",
      "Relaxes smooth muscles and opens airways",
      "Slows the heart rate"
    ],
    "answer": "Relaxes smooth muscles and opens airways"
  },
  {
    "question": "When should epinephrine be administered by EMTs?",
    "choices": [
      "For mild allergic reactions",
      "Only after contacting the ER",
      "When signs of severe allergic reaction are present",
      "Only for patients with asthma"
    ],
    "answer": "When signs of severe allergic reaction are present"
  },
  {
    "question": "What is the most common route of administration for EMTs giving epinephrine?",
    "choices": [
      "Oral",
      "Intranasal",
      "Intramuscular (auto-injector)",
      "Sublingual"
    ],
    "answer": "Intramuscular (auto-injector)"
  },
  {
    "question": "What is a possible side effect of epinephrine?",
    "choices": [
      "Bradycardia",
      "Low blood pressure",
      "Anxiety and rapid heartbeat",
      "Sedation"
    ],
    "answer": "Anxiety and rapid heartbeat"
  }
]